Mrs. S.S.P aged 65 years (Patient Identification Number 16882) visited the clinic on 4 September 2011 for the treatment of Lichen Planus. She was suffering from Lichen Planus since last 4 months. She had used oral and local steroids prescribed by her Dermat Dr. There was no major improvement in her LP.

Mrs. S.S.P presented with moderately severe Lichen Planus lesions on her face, hands, feet, neck. She had active lesions which were gradually spreading. The eruptions were blackish purple in appearance associated with severe itching and burning.

She was also a hypertensive and had high cholesterol levels; she was on regular allopathic medicines for it.

Her case was studied in detail. From the case details it appeared to be a case of steroid masked LP, where in a lot of oral and local steroids had been used, she was explained about the chances of relapse once the steroids are tapered off.

She was a non vegetarian and her appetite was good. She had craving for fish. Her urine and bowel habits were normal. Thermally she was tolerant to both the temperature. She had scanty perspiration. Her thirst for water was good.

Her sleep was slightly disturbed due to some unwanted thoughts. She was menopausal since last 15 years.

She was averagely built.

She was a House wife and her husband was a retired lawyer. She had one son and two daughters. Her daughters were settled. On asking she said that everything was well and she was very satisfied with life. We had to explain to her in detail about the importance of a detailed case taking; on probing further she opened up and then couldn’t control her tears.

She said that everything was fine but at all levels from being a wife to being a mother, her life seemed to be just bending down to everyone’s wishes. She was the one who kept adjusting in order to maintain peace. She had to give in to her husband’s dominating attitude for the smooth functioning of the family affairs. However now her patience was over and she could no longer adjust anymore.

The last 6 months were very stressful and she also mentioned that the LP also started during this time.

As a person she was very mild and gentle.

These personal stresses along with the skin Lichen Planus affected her deeply.

Dr. Rajesh Shah studied her case details and prescribed her a constitutional medicine along with research based medicines. She was given timely counseling from Dr Shah.

At 1 month follow up (12 October 2011): Mrs. S.S.P reported with no change in her LP. The spots were still very itchy and she has reduced the steroids gradually.

At the 2 months follow up (22 Nov 2011) Mrs. S.S.P reported that the itching and burning sensation was much less. The Lichen Planus eruptions had stopped spreading. She was able to stop the steroids completely with out much discomfort.

At the 4 months follow up (16 January 2012) Mrs. S.S.P reported that there was significant improvement in her Lichen Planus. No new LP spots, there was good improvement in her spots on the hands, neck and face. There were no active lesions and only the hyper pigmented marks were left. The marks are also appearing lighter. There was no itching and burning. She also mentioned having more strength to cope up with her personal stresses and feeling more positive about life.

She has been advised to continue the treatment.

(Uploaded on 3rd Feb 2012 by Dr ZAR)